Action needed to reduce toll on mental health

In case there was ever a doubt, COVID-19 is both magnifying and contributing to Canada's mental health crisis.

Let's not get bogged down in a debate about whether Canada — and Nova Scotia — had a mental health crisis, pre-COVID. The Canadian Mental Health Association says we did and their word on this is as good as any and better than most.

This week, a committee of the Nova Scotia legislature heard a stark warning from the Nova Scotia division of the CMHA.

We — society in general and the government in particular — need to “get out in front” of the mental health problems COVID is creating and exacerbating, because the alternative is a long-term legacy of mental illness and anguish that we simply can't afford, financially or morally.

“The time to act is now,” Pamela Magee, the division's executive director told the committee. “We can't wait for Nova Scotians to become ill as a result of the trauma of the pandemic.”

There is an urgent need for programs and other support to help people stay well mentally and to “bring back” to health those who are suffering, she said.

Since COVID-19 arrived, the CMHA has been swamped by people reaching out for help that they can't find in a public health system that struggled to meet the demand for mental health services before the pandemic hit.

Substance use and abuse, suicide and suicide ideation, self-harm, domestic violence and many other manifestations of poor mental health have all increased dramatically during the pandemic.

Research conducted after the first wave of the coronavirus swept Canada in the spring, found that between 20 and 25 per cent of Canadians over the age of 18 increased their alcohol consumption to try to cope with the isolation, anxiety or just the boredom brought on by the coronavirus and the necessary public health response.

The CMHA (national) also reports that seven in 10 Canadians expect the nation to suffer a serious mental health crisis as a result of the pandemic, and fully half of Canadians report worsening mental health since it began.

Not surprisingly, Canadians living in poverty suffer disproportionately from poor mental health, just as poor mental health pushes people into poverty — a vicious cycle if ever there was one.

“People with pre-existing mental illness, and particularly those with serious and complex mental illnesses, are more likely to live in poverty than others,” the CMHA reports. “These individuals have lower incomes, are less likely to participate in the labour force and are less likely to have adequate housing than (other) people …”

And there's more bad news, this time from the World Health Organization, which says COVID-19 itself can lead to neurological and mental complications, including delirium and agitation.

Additionally, people with pre-existing mental, neurological or substance use disorders are at greater risk of severe outcomes and death from COVID-19 than is the general population, the WHO reports.

The CMHA fears that if not urgently addressed now, the negative impact on Canadians' mental health will be long-lasting and place even greater strain on provincial mental health systems.

Almost from the outset of the pandemic, our political leaders have been urging us to remain hopeful, but Magee and others from the CMHA are seeing too many people who have lost hope.

Many of them are poor and paralysed by anxiety over losing — or finding — safe affordable housing or being able to put food on their tables. Hopelessness may be the most tragic of all human conditions.

The CMHA is advocating for a long-term, system-wide response that includes a range of mental health resources, supports and care. These include new, virtual models of mental health service delivery, the involvement of employers in the mental wellbeing of employees, and, perhaps most vitally, investments in the social determinants of health, notably, a living income, safe and affordable housing, food security and access to education.

For decades the WHO and CMHA have urged governments to increase mental health spending to 10 per cent of their overall health budgets. Over those decades, politicians of all stripes have embraced, but never achieved, that goal.

This year, Nova Scotia allocated just under seven per cent — about $317 million — of the province's $4.8 billion health budget to mental health services.

The next provincial budget will likely appear in the next couple of months. The most tangible evidence that the government understands the mental health crisis it faces, and is acting to address it, will be funding for mental health programs nearer 10 per cent than seven.